If you have osteoarthritis (OA), you know that learning about it and what it means for you can be confusing. Often, the x-ray is reviewed and minimal advice on how to proceed and what the outcomes mean for you are given. If you’re smart enough to ask, you might find out that about 1 in 4 people having knee replacement surgery (the most common surgery for knee OA) still have knee pain.
A couple of years ago, I went along with a patient visiting her knee replacement surgeon. This was one of the best surgeons in town and I valued his opinion. But, the education provided afterwards was not very thorough. It was basically a shrug of the shoulders and the patient was told “You can do what you like. If your knee still bothers you, I am here.” While I applaud the lack of pushing someone into surgery, I wish there was better education on what patients can actively do to avoid surgery. There are several things that we know are effective. We also know that arthritis in a joint doesn’t always get worse with time, which is sometimes implied.
So, if you or someone you know has knee OA and you’re trying to figure out what the best next step is, look no further. Just this year, a study was published in The Journal of Arthroplasty entitled, “The Outcomes of Nonoperative Management of Patients With Hip and Knee Osteoarthritis Triaged to a Physiotherapy-Led Clinic at Minimum 5-Year Follow-Up and Factors Associated With Progression to Surgery.” In the study, patients with mild to moderate knee OA and hip OA were referred to a clinic where they (among other things) got education on their condition, nutrition advice, and a referral to PT.
When following up 5-7 years later, about half of the knee patients had avoided surgery altogether and were doing just fine. About 1 in 4 of the hip OA patients had still avoided surgery. The average age in the study was about 68 years. It did appear that people with less severe knee OA had a better chance of avoiding surgery than those with more severe knee OA.
Gwynne-Jones JH, Wilson RA, Wong JMY, Abbott JH, Gwynne-Jones DP. The Outcomes of Nonoperative Management of Patients With Hip and Knee Osteoarthritis Triaged to a Physiotherapy-Led Clinic at Minimum 5-Year Follow-Up and Factors Associated With Progression to Surgery. J Arthroplasty. February 2020. doi:10.1016/j.arth.2020.01.086.